Precious Matsoso

The Department of Health is planning to revise the National Health Act’s controversial provisions for regulating where doctors work, it emerged on Tuesday.

The development will allow doctor associations a fresh opportunity to lobby the government, but does not mean the policy is off the political agenda.

Health director-general Precious Matsoso said the principle of the so-called certificate of need, which aims to direct healthcare resources to areas where the government believes they are required, was "not in question", but some of the concerns raised by the healthcare industry needed to be taken into account.

The Department of Health will launch a specialised institute of regulatory medicine in April as one of the measures to improve the capacity of the Medicines Control Council (MCC) to approve new drugs and clinical trials, health director-general Precious Matsoso said on Tuesday.

GENEVA, January 23, 2014 - In a meeting with Universities Allied for Essential Medicines (UAEM), South African Director General of Health Malebona Precious Matsoso strongly criticized a leaked proposal by the pharmaceutical industry lobby to undermine access to medicines in South Africa.

The leaked plan from Public Affairs Engagement, a lobbying firm based in Washington, D.C., focused on halting reforms to South Africa's intellectual property laws that would expand access to life-saving drugs. The firm outlined a subversive grassroots campaign to cast doubt on the well-established link between patent-protected prices and limited drug access for lower-income South Africans.

Government has raised concerns that the health system may buckle under the pressure of both HIV and non-communicable diseases - a dual epidemic.

National health director general Precious Matsoso has warned that the current rate of non-communicable diseases such as diabetes, heart-related conditions and cancers pose a threat to the government's planned National Health Insurance system. "I hope South Africa's fight against these conditions will be fought with the same vigour and yield the same results as the fight against HIV has. If such diseases are not curbed, it could see the South African public health system put under a lot of strain in 10 years' time," Matsoso said.

A YEAR after the government launched its National Health Insurance (NHI) pilot project, a third of the districts involved in the experiment have spent barely half their allocated budgets, according to a government-commissioned review presented to Parliament on Wednesday.

The slow pace of expenditure highlights the patchy progress being made by the project, which is running in 11 health districts. It was launched in April 2012, and allocated a R150m conditional grant for the fiscal year 2012-13, with some provinces adding extra funds. According to the Division of Revenue Act, the grant was intended to strengthen the health system in the selected districts, test innovations necessary for implementing NHI and strengthen revenue collection at central hospitals.

THE Department of Health still cannot say when the much-delayed South African Health Products Regulatory Agency (Sahpra) is likely to come into effect.

Despite the April 1 target set by last year’s health budget vote, there is still no sign of the new entity. The department envisaged Sahpra as the solution to the problems besetting the medicines regulator, the Medicines Control Council (MCC), which takes longer than regulators in the US and Europe to approve new drugs or clinical trials.

GPs with their own practices are interested in working for the NHI scheme – with caveats.

Last week, Bhekisisa reported that 350 private doctors will start working part time for the country's National Health Insurance (NHI) system this month at public health facilities. The clinics and hospitals are based at the NHI scheme's 11 pilot sites.

A poisonous snake slithering through a district hospital, badly cracked walls and rooms filled to the roof with broken equipment were some of the challenges facing researchers as they conducted the first national audit of public health facilities.

For most of last year, 20 data collection teams visited 3 880 public health facilities, throughout the country, ranging from tiny clinics to national central hospitals. The vast majority – 3 074 – were clinics.

The aim was to assess all public health facilities according to six criteria so that problems could be identified and addressed.

In the first of a two-part series about the NHI, Mia Malan reports on state plans to change the rigid reimbursement formula for private doctors.

About 350 private doctors have told the health department that they would like to sign contracts to work part-time at rural public health facilities in National Health Insurance (NHI) pilot sites, according to the department of health's director general, Precious Matsoso. She said most of them would start work in May.

"We have had overwhelming interest, but will first ensure that the clinics where such doctors will be employed are fully equipped and have passed our readiness assessment tests," said Matsoso.